Prevalence and profile of patients on antipsychotics in a hospital in southern Brazil
DOI:
https://doi.org/10.15448/1980-6108.2015.4.21373Keywords:
antipsychotics, haloperidol, mental disorders, anxiety.Abstract
Aims: To evaluate the prevalence and the profile of inpatients prescribed antipsychotics.
Methods: This was a cross-sectional study which evaluated patients admitted to Hospital Nossa Senhora da Conceição (HNSC), in Tubarão, State of Santa Catarina, Brazil, in 2013, who were prescribed antipsychotic drugs. All the data were collected from electronic medical records. Patients were evaluated according to their sociodemographic characteristics, type of antipsychotic drug prescribed, and clinical diagnosis (ICD 10).
Results: Out of 125,670 patients admitted to HNSC in 2013, 1,559 received some kind of antipsychotic. The mean age of the patients was 50.34 years (SD=22.89). There was no variation in the prevalence of antipsychotic drug prescription between male and female patients, but the frequency of these prescriptions increased with age. Conventional antipsychotics were the most commonly prescribed ones, among which haloperidol was prescribed to 852 (54.7%) patients. Among the major diagnoses, anxiety disorders were the most prevalent ones, detected in 131 (6.3%) patients. Considering only the diagnoses of mental or behavioral disorders and including secondary diagnoses, anxiety disorders were observed in 233 (14.9%) patients. A total of 470 (30.1%) patients on antipsychotics had been diagnosed at least once with mental or behavioral disorders.
Conclusions: The prevalence of antipsychotic drug use was 1.24% among the inpatients, and haloperidol was the most widely prescribed drug. The diagnosis of anxiety disorders was the most frequent one, but most patients who received antipsychotics had not been diagnosed with any psychiatric disorder, and eventually received them for other reasons.
Downloads
References
World Health Organization. WHO model list of Essential Medicines 19th Ed [Internet]. Geneva; 2015. [cited 2015 May]. Available from: http://www.who.int/entity/selection_medicines/committees/expert/20/EML_2015_FINAL_amended_AUG2015.pdf?ua=1
Costa KS, Barros MBA, Franscisco PMSB, César CLG, Goldbaum M, Carandina L. Utilização de medicamentos e fatores associados: um estudo de base populacional no Município de Campinas, São Paulo, Brasil. Cad Saúde Pública. 2011;27(4):649-58. http://dx.doi.org/10.1590/S0102-311X2011000400004
Lambrey S, Falissard B, Martin-Barrero M, Bonnefoy C, Quilici G, Rosier A, et al. Effectiveness of clozapine for the treatment of aggression in an adolescent with autistic disorder. J Child Adolesc Psychopharmacol. 2010;20(1):79-80. http://dx.doi.org/10.1089/cap.2009.0057
Faculdade de Medicina da Universidade de São Paulo. Interações medicamentosas em psiquiatria [Internet]. São Paulo; 2014. [cited 2015 May]. Available from: http://www.ipqhc.org.br/pdfs/Psico.pdf
Page VJ, Ely EW, Gates S, Zhao XB, Alce T, Shintani A, et al. Effect of intravenous haloperidol on the duration of delirium and coma in critically ill patients (Hope-ICU): a randomised, double-blind, placebo-controlled trial. Lancet Respir Med. 2013;1(7):515-23. http://dx.doi.org/10.1016/S2213-2600(13)70166-8
Komossa K, Rummel-Kluge C, Schwarz S, Schmid F, Hunger H, Kissling W, et al. Risperidone versus other atypical antipsychotics for schizophrenia. Cochrane Database Syst Rev. 2011;19;(1):CD006626. http://dx.doi.org/10.1002/14651858.cd006626.pub2
Divac N, Prostran M, Jakovcevski, Cerovac N. Second-generation antipsychotics and extrapyramidal adverse effects. Biomed Res Int. 2014;6(5)63-70. http://dx.doi.org/10.1093/schbul/sbq042
Meltzer HY, Matsubara S, Lee JC. Classification of typical and atypical antipsychotic drugs on the basis of dopamine D-1, D-2 and serotonin2 pKi values. J Pharmacol Exp Ther. 1989;251(1):238-46.
Khasawneh FT, Shankar GS. Minimizing cardiovascular adverse effects of atypical antipsychotic drugs in patients with schizophrenia. Cardiol Res Pract. 2014;2(7)30-60. http://dx.doi.org/10.1155/2014/273060
Pereira MO, Souza JM, Costa AM, Vargas D, Oliveira MAF, Moura WN. Perfil dos usuários de serviços de Saúde Mental do município de Lorena – São Paulo. Acta Paul Enferm. 2012;25(1):48-54. http://dx.doi.org/10.1590/S0103-21002012000100009
Pincus HA, Tanielian TL, Marcus SC, Olfson M, Zarin DA, Thompson J, et al. Prescribing trends in psychotropic medications: primary care, psychiatry, and other medical specialties. JAMA. 1998;279(7):526-31. http://dx.doi.org/10.1001/jama.279.7.526
Gonçalves DP, Silva IV, Rangel LB, Rezende LC. Prescription of psychoactive drugs in patients attended by the SUS at Manhuaçu – MG (Brazil). Pharmacy Practice. 2011;9(4):200-6. http://dx.doi.org/10.4321/S1886-36552011000400004
Agency for Healthcare Research and Quality (US). Future Research Needs for First- and Second-Generation Antipsychotics for Children and Young Adults [Internet]. Rockville; 2012 [cited 2015 May]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK84656/
Machado FB, Gomes MF, Junior SEM, Mella EAC. Determinação dos antipsicóticos utilizados no hospital municipal de Maringá – Paraná. Semina Cienc Biol Saúde. 2009;30(1):77-82.
Powney MJ1, Adams CE, Jones H. Haloperidol for psychosis-induced aggression or agitation (rapid tranquillisation). Cochrane Database Syst Rev. 2012; 14;11:CD009377.
Diógenes AR, Rodrigues FC, Xavier CA, Guerra GC, Alves MSCF, Ferreira AA. Análise da relação custo e consumo dos antipsicóticos típicos e atípicos: implicações para a saúde pública. Rev Ciênc Méd Biol. 2007;6(3):275-81.
Horn M, Vaiva G, Dumais A. Drug management of agitation in emergency departments: theoretical recommendations and studies of practices. Presse Med. 2015 Jan;44(1):20-6. http://dx.doi.org/10.1016/j.lpm.2014.04.027
Nieto RR, Silva HI. Prescripción de antipsicóticos atípicos en pacientes hospitalizados de la Clínica Psiquiátrica Universitaria. Rev Chil Neuro-psiquiat. 2008;46(1):16-24. http://dx.doi.org/10.4067/S0717-92272008000100003
Shirama FH, Miasso AI. Consumo de psicofármacos por pacientes de clínicas médica e cirúrgica de um hospital geral. Rev Latino-Am Enfermagem. 2013;21(4):1-8.
Arilla JA, Fernández ME, Vi-uales E, Lozano I. Politerapia antipsicótica en una unidad de hospitalización psiquiátrica. Rev Psiquiatr Salud Ment (Barc). 2010;3(3):90-6. http://dx.doi.org/10.1016/j.rpsm.2010.04.001
Baldaçara L, Sanches M, Cordeiro DC, Jackowski AP. Tranquilização rápida para pacientes agitados nos serviços de emergência psiquiátrica: um ensaio clínico randomisado de olanzapina, ziprasidona, haloperidol mais prometazina, haloperidol mais midazolam e haloperidol em monoterapia. Rev Bras Psiquiatr. 2011;33(1): 30-9. http://dx.doi.org/10.1590/S1516-44462011000100008
Young SL, Taylor M, Lawrie SM. "First do no harm." A systematic review of the prevalence and management of antipsychotic adverse effects. J Psychopharmacol. 2015;29(4):353-62. http://dx.doi.org/10.1177/0269881114562090
Downloads
Published
How to Cite
Issue
Section
License
Copyright
The submission of originals to Scientia Medica implies the transfer by the authors of the right for publication. Authors retain copyright and grant the journal right of first publication. If the authors wish to include the same data into another publication, they must cite Scientia Medica as the site of original publication.
Creative Commons License
Except where otherwise specified, material published in this journal is licensed under a Creative Commons Attribution 4.0 International license, which allows unrestricted use, distribution and reproduction in any medium, provided the original publication is correctly cited.